Narrative descriptions of miyo-mahcihoyān (physical, emotional, mental, and spiritual well-being) from a contemporary néhiyawak (Plains Cree) perspective

BACKGROUND: There are unequivocal health disparities, both physical and mental, between the Indigenous and non-Indigenous peoples of Canada. METHODS: Utilizing narrative inquiry, 15 néhiyawak (Plains Cree people) between 18 and 71 years of age from Thunderchild First Nation were interviewed to explore what improved their mental health and well-being and what they needed to attain optimal mental health and well-being. By posing questions that focused on the positive, the strengths and resilience of the néhiyawak came to the forefront. RESULTS: Narrative thematic analysis of interview data consistently revealed four overarching themes that highlighted what positively impacted néhiyawak mental health and well-being and their perceived needs to attain optimal mental health and well-being: relationships; spiritual beliefs and cultural practices; tānisīsi wāpahtaman pimātisiwin (worldview); and ēkwa ōhi kikwaya piko ka-ispayiki kīspin ka-nohtē-miyo-mahcihoyān (these are the things that need to happen if I want to be healthy). The néhiyawak in this study described holistic health determinants that correlate with the medicine wheel and the determinants of health, and described these holistic health determinants as making a positive difference to their mental health and as necessary for them to obtain optimal mental health and well-being. CONCLUSIONS: These results suggest that mental health programming and interventions should be harmonious with Indigenous culture; utilize a holistic approach that takes physical, emotional, mental, and spiritual well-being into consideration; and address the existing mental health disparities using the determinants of health as a framework, with an increased focus on the current socio-economic status of Indigenous peoples in Canada.